23562_FAULKNER, THOMAS H AND DEBRA_19991112

CAMA and DREDGE AND FILL A
G E N E R A L :i.. 23562
PERM I T
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name Phone Number
Address
City State zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project is consistent with the local
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work.
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
issuing date
(SCALE: )
applicant's signature
permit officer's signature
expiration date
attachments
application fee

THOMAS H. FAULKNER
1061
EVELYN—O. FAULKNER
8 BEACHBAY LANE
66-30/ 3t
WILMINGTON, N. C. 28405155
Date
Pay to the
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Order of i�
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Dollars
FIRST CITIZCNS,BS
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A �(�I FlrstLttizens Bank 8 Trust Company
Kinston, N.C. 2B501
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For
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05/07/1999 04:04 8033590964 M A KLINE PAGE 01
�6' d "1H101
ADJACENT RIPARIAN PROPERTY OVWNER S'TATEMW
(FOR A PIERIMOORING PILINGSIROATLMPT/ROAI"MOUSE)
I hcreby certify that I own property adjacent to om' 1 i • 04; ::' I
Name of Property Owner)
propc:ty located at 3
rr (Lac, Block, Road, etc.)
an _rc�r.C- U�u,.� , is , N.ir.
(vVaterbody) (Town and! ounty)
He has described to me, as shown below, the development he is prgvsiug at U` zt
location, and, I have no objections to his proposal. I undentand that s pier/mooring
pilings/boatliftfboathousc must be net back a minimum distance of fift= feet (15') from my area
of riparian access unless waived by me.
—X - I doh wish to waive the setback requirement.
I to wish to waive that setback tequurmenL
DESCRnMON &VD/OR DRAWNG OF PROPOSED DEVELOPMEYr:
(To be j'Ukd in by in&idual proposing development)
zd 3
a I k (i r,
Print or Type Name
Telephone umber
Date:
7A i7s ' -4 ec" 77? 7C7 1 -4 1 H 1 ti :4 KjHrl i -71fTC is 1 :�A I I : C' I J=9A I -q2-MH

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to_ 1--2 e v s
�1 (Name of Property Owner)
property located at t�l I )�G %c� �, 11 ?0- ) v-C.
(Lot, Block, Road, etc.)
on 606U"-;' Sour A, � , in �' Pr.2 T-e&- le. F N.C.
(Waterbody)
(Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
� j
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE) - j f �
I hereby certify that I own property adjacent to 74a�,-tom � � kl,�jq� 's
(Name of Property Owner)
property located at �� � 3 �'� �
(Lot, Block, Road, etc.)
on G - - <J o'. "f in , N. C.
(Waterbody) (Town and/ ounty)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatliftlboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
iC I do not wish to waive the setback requirement.
A
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
T
L.01 V r � � I � S
Print or Type Name
Telephone N ber
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
g) th vrrws -t'-� v'eAN 1 -
I hereby certify that I own property adjacent toy `P `� 's
(Name of Property Owner)
property located at °� ��► P IY►C�Zt1? CfvL1 )/�? .
r (Lot, Block, Road, etc.)
on 6U Iiv a e-_ 5 0 i,,w C in (,q-t 4 exe- i �'
, N. C,
(Waterbody)
(Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
004 lg- A e-v, A
1 , 6� -/1;
11t, �t"'�J /( )
Signature_ / j
Print or Type Name
Telephone Number
Date:

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